John Tasioulas the Director of the Yeoh Tiong Lay Centre for Politics, Philosophy and Law at The Dickson Poon School of Law, King’s College London. He has held visiting appointments at the Australian National University, the University of Chicago, Harvard University, and the University of Melbourne, and has acted as a consultant on human rights to the World Bank.  He is the author of two recent reports for the World Bank: Minimum Core Obligations: Human Rights in the Here and Now and The Minimum Core of the Human Right to Health, which are the subjects of this symposium.

Overview

I am indebted to the commentators for their insightful responses to my work on minimum core obligations (MCOs). I am also very grateful to James Stewart for assembling commentators who, as a group, reflect the dauntingly multi-disciplinary character of the topic. In the course of writing the two reports, it became increasingly clear to me that a major obstacle to progress is the lack of genuine communication across disciplinary boundaries, a problem in no way confined to the academy. I hope that this symposium contributes in some small way to overcoming this obstacle.

It will be useful to begin with a brief summary of the two reports. [1] The aim of the first report was to explore the concept of MCOs, as it has emerged in contemporary human rights law and practice, with a view to identifying (a) whether it can be given a clear and coherent articulation, (b) whether this concept adds significant value to human rights discourse, (c) how minimum core obligations should be identified and their content specified, and (d) whether compelling responses could be given to some of the leading objections to the doctrine of MCOs. My answers to these questions were, in brief, as follows: (a) that there is a clear and coherent idea of MCOs, centred on the sub-set of obligations of economic, social and cultural rights that are to be immediately complied with in full by all states irrespective of resource variations among them. To this extent, MCOs impose a limit to the operation of the doctrine of progressive realisation in relation to such rights. Contrary to the views of some commentators, MCOs do not of their very nature possess the additional features of non-derogability, a special grounding, or justiciability. Whether any given MCO possesses any of these further features is a matter to be determined on the individual merits, case-by-case; (b) that the value of MCOs resides in the way that they help address the problem of prioritising compliance with human rights obligations when it is not feasible to comply immediately with all such obligations; (c) that MCOs are to be identified by a process that involves (i) attention to the proper scope of a given right, (ii) due regard for considerations of feasibility – in particular, possibility and burdensomeness – in shaping MCOs, (iii) the holistic character of specifying MCOs, so that they are jointly feasible as obligations of immediate effect when taken as a totality, and (iv) the need for a specification of MCO that is invariant in content across different societies; and (d) that two leading objections to MCOs – that they impose an unduly restrictive strait-jacket on human rights thinking, and that they are potentially counter-productive in effect – can be answered.

The second report, on the right to health, was rather more descriptive in character. It offers an inevitably limited overview of how the notion of MCOs has played out in international, regional and domestic legal contexts. However, there is an important link between the two reports, because I use the concept of MCOs developed in the first report as a basis for both interpreting and evaluating certain legal and other developments in this domain. So, for example, one of my chief interpretative claims is to cast doubt on the sweeping assertion that the important South African jurisprudence has jettisoned the doctrine of minimum core in favour of an overall assessment of reasonableness. [2] This mistaken view stems from the failure to distinguish the question whether a given minimum core obligation exists as a matter of law from whether the question that obligation is justiciable, in the sense of effectively enforceable by individual litigants through judicial orders granting them their entitlements under MCOs. The clarification of the concept of MCOs offered in the first report enables us to see that the South African jurisprudence can be interpreted as rejecting the justiciability of minimum core obligations while nonetheless embracing both their existence and their relevance within a broader reasonableness test. On the more critical front, the report argued that General Comment 14 offers an unduly broad and lavish specification of MCOs under the right to health and, more positively, sketched the role that MCOs in relation to the human right to health can play in advancing key aspects of the health-related SDGs, especially universal health care.

Law and Morality

My investigation of MCOs, especially in the first report is not, primarily, a legal project, but rather a moral-political enterprise, one with potentially important implications for law. These implications arise in virtue of the background theoretical stance I set out at the start of the report. According to this, the formative aim of international human rights law is to give effect, insofar as it is appropriate for it to do so, to a background morality of human rights. Given that connection, three legal consequences follow from the vindication of a clear, coherent and morally compelling conception of MCOs: (a) it bolsters the case for enshrining MCOs in law; (b) insofar as the best interpretation of the International Convenant on Economic, Social and Cultural Rights (ICESCR) turns on the ability of that Covenant to fulfil its aims – which is the implementation of a certain aspect of human rights morality – to that extent there is a pro tanto case for regarding the MCO doctrine as part of the best interpretation of that Covenant; and (c) on a non-positivistic interpretation of customary international law, of the kind I have developed in other writings, the moral attractiveness of the MCO doctrine has a positive but non-conclusive bearing on its legal status.

However, I refrained from definitively claiming that MCOs are part of the best interpretation of the ICESCR, let alone that they are norms of customary international law. In the latter context, I was content to suggest that it is at least ‘nascent’ law or what might otherwise be called ‘soft law’. I did not take this further step because I felt that the moral question is logically prior and more pressing, but also because I did not wish to get embroiled in debates about the sources of law or treaty interpretation, such as the status to be accorded to General Comments produced by treaty bodies in either of these contexts. I welcome Michael Kirby’s insightful commentary as nudging me further on the legal side – in a direction I am not unhappy to be nudged – by mobilizing considerations of text, context, history and legal policy to affirm the legal status of minimum core obligations, at least with respect to the correct interpretation of the ICESCR.

We can now also see how Martha Nussbaum’s marvellously provocative and wide-ranging comment misinterprets the aim of the first report. Nussbaum appears to believe that I sought to establish that MCOs already exist as a matter of international law and that, in virtue of this, states have a moral obligation (perhaps enforceable erga omnes) to comply with them. In light of her generally dismissive attitude towards the legitimacy of international law, where it has not been endorsed by democratic processes within states, she is accordingly sceptical of the normative upshot of my imagined argument. But what I was concerned to argue is that there is a good reason for believing in MCOs as part of human rights morality and, to the extent appropriate, enshrining them in international law (as Nussbaum also appears to recognise in observing that “Tasioulas always emphasizes that the norms in question are moral norms” and in saying I provide good moral arguments for them). The argument was made against the background assumption that there is a defensible human rights morality and that the ICESCR broadly reflects the content of many such human rights. Nothing in Nussbaum’s comment, therefore, directly touches the main line of argument deployed in either report.

Nevertheless, both of my reports can fairly be seen as receptive to the idea that if MCOs were embodied in international law, this would count in favour of a further, legally-based moral obligation of compliance with them. It is this assumption that Nussbaum challenges on the basis of the need to probe more deeply into the legitimacy of international law. In particular, the need to address how the claims of international law (whether treaty-based or customary international law) to obedience by states can be reconciled with the sovereignty enjoyed by those very same states. Why should states be bound by such norms if they have not endorsed them through their internal democratic political processes?

Faced with this question, I must confess, I feel a little like a plumber who has been called in to fix a leaky tap being asked to give a theory of the universe as a proper intellectual underpinning for his repair work. The reason that I did not directly address Nussbaum’s big theoretical question in either report was that, following the lead of authors like John Rawls, Cass Sunstein, and indeed Nussbaum herself, I believe that my analysis of MCOs has a self-standing quality, enabling it to be endorsed by those with widely divergent answers to that question. I did not want to prevent readers from coming to such an ‘overlapping consensus’ on MCOs by unnecessarily dragging in my views on contentious philosophical questions about how state sovereignty, democracy and the legitimacy of international law should be knitted together. Nevertheless, Nussbaum is entirely correct to suggest that some kind of answer to her question is required in a fuller philosophical theory in which MCOs are a small but important fragment.

Although this is not the place to sketch the overarching theoretical structure that Nussbaum demands, even if I could do so, it is worth pointing out that I would reject both of the two alternatives that she postulates. These alternatives are world government and (her democratic version of) the Grotian approach. The first alternative I would reject for reasons made familiar by Kant and, more recently, endorsed by Rawls. A unitary global state would provoke such massive resistance that it would lapse into widespread anarchy. Or else, assuming it could quell such resistance, this would be at the cost of tyrannical oppression. But the second, Grotian alternative is also unacceptable. This is because it makes the bindingness of international law in general conditional on its acceptance by the citizenry of a democratic polity. On this view, as Nussbaum puts it, international legal norms will “actually count as [morally binding] law when nations have [accepted them] through their internal, democratically accountable procedures”. The unsatisfactoriness of this alternative is most evident in the case of non-democratic states. Was apartheid era South Africa, for example, not bound by the jus cogens norms prohibiting racial discrimination and apartheid, given that it not only did not accept any such norms but vociferously protested against them? [3] But even democratic states, such as America, may be bound by norms of international law, such as norms outlawing military intervention and torture, irrespective of whether those norms have been domestically validated. Of course, it is a further question whether, and if so how, morally binding legal norms should be enforced against states the violate them. In other words, although international law must be respectful of the sovereignty of individual states (hence, a thumbs down to world government), it does not follow that it only binds if its norms are validated by the internal processes of democratic polities (hence, a thumbs down to Nussbaum’s take on Grotianism).

Nussbaum’s formulation of the Grotian view, which she favours, has surprising affinities with the profound scepticism towards international law propounded in recent decades by American neo-conservatives. [4] And this general impression of affinity is reinforced by the vehemence of her condemnation of the UN system as “grotesquely flawed and corrupt, totally lacking in democratic accountability, and therefore devoid of any procedural legitimacy when it comes to imposing law on people”. Nevertheless, such views, I believe, go overboard in their wholesale denial of any source of legitimate authority beyond the democratic nation state. In other writings, I have sought to sketch some of the contours of a more pluralistic conception of the global legal order, one which enables international (human rights) law to have binding authority over states that does not stem from the democratic validation of its norms, but rather from its satisfaction of the classical requirement that it enhances the conformity of states and other actors with the demands of an objective order of reason. [5] However, a condition of international law’s ability to enjoy such legitimacy is a proper respect for the (limited) claims of state sovereignty of both democratic and non-democratic states. These claims include, I believe, a limited leeway to depart from human rights demands in certain respects. There doubtless remains a lot more work to be done on these topics, especially that of elaborating on the requirement of properly respecting state sovereignty, and I hope I will have the good fortune to contribute to it with the continuing benefit of Martha Nussbaum as a main interlocutor.

Human Rights, Obligations and Feasibility

As can be seen from the responses of my commentators, the topic of MCOs polarizes informed opinion. Michael Kirby forcefully concludes that a “necessary” part of the analysis of the right to health is the inclusion of MCOs and suggests that in their absence that right would be “meaningless and devoid of real content”. In diametric opposition, Max Harris contends that the doctrine of MCOs “hollows out the potential of fully realised economic, social, and cultural rights”. It is important to register that many of these differences of opinion trace back to deeper divisions about the nature of both human rights morality and international human rights law in general, including how these two bodies of norms are related. It is therefore worth going back to these fundamentals before broaching the more specific questions regarding MCOs.

On the view adopted in my reports, international human rights law (IHRL) has as its formative aim the giving effect to a background set of moral human rights, insofar as it is appropriate to do so, by means of conferring international legal rights on all individual human beings. [6] It is this formative aim that distinguishes IHRL from other departments of international law, such as the law on the use of force or trade law. These other departments may also be vitally concerned with human rights – indeed, one of the major sources of human rights disasters in our world is illegal military interventions. But they are not concerned with human rights in the same way as IHRL is supposed to be: they are not centrally focussed on moral human rights nor on the furtherance of such rights through the specific legal technique of conferring legal rights on all individual human beings.

Given that IHRL should be, in this way, responsive to a background morality of human rights, it is important to be clear about the latter’s nature. In the first report, I emphasized the fact that human rights differ from interests in that they necessarily have obligations associated with them. Moreover, the process of identifying and specifying the content of these obligations must take into account a number of key considerations: (a) the scope of the relevant right – so, for example, I claimed that the scope of the right to health includes obligations pertaining to medical treatment, public health measures, and certain social determinants of health. Hence, obligations not to torture or to provide adequate food do not come under the right to health, even though they serve our interest in health, but rather are associated with other rights (i.e. the rights not to be tortured, and to food / an adequate standard of living); (b) the possibility of those who are subject to the obligations generally being able to comply with them, since ‘ought implies can’ rules out the existence of obligations that cannot, as a general matter, be complied with; (c) that the putative obligations associated with a given right are not excessively burdensome in terms of the costs they impose of those who bear the obligations, which explains why there cannot be a right to the ‘highest attainable’ standard of health on any strictly literal construal; and (d) the holism constraint that requires that the whole set of human rights we wish to recognise must be feasible – generally possible, and not excessively burdensome, to comply with – as a group, and not simply taken one-by-one. On my view, conceiving of human rights as involving obligations is essential to grasping their moral importance: obligations are moral reasons it is blameworthy to violate and which are in general strongly, but not absolutely, resistant to being overridden by competing considerations.

Sakiko Fukada-Parr’s thoughtful response shows that I needed to be clearer in the reports about what I meant in saying that human rights obligations, including obligations that belong to the sub-set of minimum core obligations, must comply with a requirement of not being unduly or excessively burdensome. Fukuda-Parr seems to believe I embrace the following two propositions about MCOs: (a) that they impose immediate obligations only regarding the provision of ‘low cost’ goods and services, and (b) that cost is a function of their market price. Having interpreted my views in this way, she understandably draws the conclusion that they lead to an ‘unnecessarily restrictive’ interpretation of MCOs. Fukuda-Parr’s critique would indeed be on target if I were committed to propositions (a) and (b). However, I reject both propositions, and explicitly so in other writings. Hence, for example, the following claim about the relevant sense of ‘cost’ or ‘burden’ in shaping obligations associated with rights:

“It is important to keep in mind, however, that ‘cost’ here is not a simple function of the real world market price of various medical services and public health measures. So, for example, one cannot simply take as given the market price that pharmaceutical companies, exploiting their market position and the rights afforded to them by intellectual property law, actually charge for their products.” [7]

Fukuda-Parr’s misreading of my feasibility criterion suggests that I should have explicitly reiterated that rejection in the first report. However, even in that report I nowhere state that MCOs must be ‘low cost’, only that they must not be ‘unduly burdensome’ to be imposed as obligations of immediate effect upon all states. The repeated qualifier ‘unduly’ is meant to allow for the possibility that burdensome demands may well be minimum core obligations. Just as a parent may have an obligation of immediate effect to risk their life in order to save their child’s life (but not to save the child’s finger from being scratched), so too a state may have an obligation of immediate effect to roll out a very costly vaccination program. The issue is always a matter of whether serving individual right-holders’ interests in a certain manner is something that it is not unduly burdensome to impose as an obligation. This will depend on the weight of the interest, the cost of fulfilling it via compliance with the supposed duty, and whether that cost is not an excessive demand on the putative duty-bearer given the benefit to the putative right-holder. Second, the ‘cost’ in question cannot simply be the price as determined by any existing institutional structure, such as the existing legal and economic arrangements regarding intellectual property rights. This would make the existence and content of human rights a function of arrangements that may themselves be deeply morally flawed because they embody certain forms of unfairness or enable relations of exploitation. Instead, cost essentially involves the burdens on resources that imposing an obligation would create given other potential ways of using the same resources. In this connection, the question arises whether it would be ‘unduly burdensome’ on pharmaceutical companies, say, to reduce significantly the unprecedented levels of intellectual property rights they currently enjoy in order better to serve the interests of those in need of access to various medicines. One way of expressing my sympathy with Fukuda-Parr’s powerful call to rebalance the right to health and intellectual property rights in favour of the former is to say that it would not be.

The issue of feasibility also crops up in Max Harris’ lively comment. Although Harris may allow that human rights (in morality or law), involve what might loosely be called ‘obligations’, he seems ambivalent about allowing considerations of feasibility ((c) and (d) above) to determine their content. Of course, I agree with him that judgments about feasibility are ‘value-laden’, but so is the judgment that feasibility should not be taken into account. The real task that confronts us is to make correct judgments about feasibility in shaping human rights norms. In this regard, I wondered who he was disagreeing with in observing that “Statements by present-day governments of what is feasible should not necessarily be accepted at face value. It might be that with significant rearrangements of those governments’ activities, enforcements of economic, social, and cultural rights would be eminently feasible”. Just as nothing in my reports endorsed market price as the ultimate determinant of burdensomeness, nothing I said endorsed taking governments’ statements about feasibility (or indeed anything else) at face value. Questions about the feasibility of human rights – about whether it is possible, or not unduly burdensome, to comply with their associated obligations – are often complex and difficult and not to be settled either by a brute appeal to price or to the (often) self-serving or obtuse say-so of governments. [8]

I will return to some of Harris’ specific criticisms of the doctrine of MCOs in the next section. But it is worth mentioning here one of the two pathways he endorses as alternatives to MCOs, which is a test of ‘proportionality’ that has become widely popular among constitutional lawyers. This is because it brings out deeper divergences in how we understand human rights and their relation to obligations. The proportionality approach casts the net extremely widely in identifying human rights, which basically consist in any legally cognizable interest. It then asks whether the measures complained of as infringing that human right might nonetheless be justified on a proportionality analysis that takes into account valid purposes served by the infringement. This proportionality approach may well avoid a role for minimum core obligations, as Harris suggests, but perhaps only at the drastic cost of failing to engage with anything recognisable as obligations at all. The upshot, as one of the leading exponents of the proportionality approach makes clear, is that to assert the existence of a human right is not to assert very much at all: “a rights-holder does not have very much in virtue of having a right… An infringement of the scope of a right merely serves as a trigger to initiate an assessment of whether the infringement is justified”. [9] Harris’ fears about ‘hollowing out’ human rights seems to return here, and with a vengeance, threatening to defeat pretty much any aspect of the supposed right possessed by the right holder.

Obviously, it is a live question which approach takes human rights more seriously: the view that says the obligations associated by human rights are not readily justifiably defeated versus a proportionality approach which does not confer on rights this general, but not absolute, resistance to being overridden. My own view, however, is that preserving the link with obligations that are generally resistant to defeat is crucial to the significance of human rights. [10] In this sense, one is asserting quite a lot in claiming that there is a human right not to be tortured or a human right to health. But, on a more purely political note, I also believe that the ‘proportionality’ approach, which recognises human rights to a lavish array of goods, yet is simultaneously ready to countenance extensive justified infringements of any such right, exemplifies the kind of ‘giving with one hand and taking away with the other’ that has brought the idea of human rights into disrepute in many societies.

In addition to the doctrine of proportionality, Harris concludes by mentioning another alternative to MCOs: “developing a more refined account of what is contained in individual economic, social and cultural rights”. But who could possibly object to giving such an account? But can this be done without taking very seriously the idea that such rights “contain” obligations that are not readily overridden, partly because they are shaped ab initio by considerations of feasibility? I doubt it. And, as I explain in the next section, the rights will also include MCOs, once we have dispelled Harris’ misconceptions about them. So, the second alternative to MCOs is, I believe, no real alternative at all.

I turn now to Sarah Hawkes’ comments, which make two vital observations that bear on an approach to global health policy that draws on human rights, including MCOs. The first observation is the importance of measures for maintaining the health of populations, including the prevention of illness and disease, alongside measures for treating people once they have become sick. Second, we need to consider how the determinants of health and illness have changed over time, with the rise in the 21^st Century in the importance of factors such as over-consumption, corporate behaviour and lack of effective state governance.

I think both of these observations are entirely correct and that they have numerous significant implications for global health policy and human rights which are reflected in various ways in both of my reports and other of my writings. First, and most obviously, they help shape the obligations associated with the human right to health, including its MCOs. These will not only include obligations concerned with the treatment of the sick, such as obligations to afford them access to essential medicines, but also obligations pertaining to public health measures, such as vaccination, and to certain social determinants of health. It is important to observe here that the content of human rights will evolve over time in line with new challenges and opportunities for fulfilling our interests and variations in the cost of meeting the challenges and exploiting the opportunities. Secondly, when it comes to human rights, global health policy will need to rely on more than just the right to health, contrary to a thesis promoted by Lawrence Gostin and his associates. The right to health is, I have argued, limited in scope to obligations concerning the delivery of medical treatment, public health measures, and some but not all social determinants of health. But there are other human rights that play an important role in maintaining health or preventing its deterioration, such as the rights to political participation, non-discrimination, access to food and water, and to education. The latter is especially salient in view of the powerful role that the increase in women’s education has played in reducing mortality. Third, global health policy cannot take the measure of Hawkes’ observations without going beyond a normative framework focussed exclusively on human rights. A sound global health policy must also take on board non-human rights considerations, such as duties to preserve one’s own health or duties to foster the common good that are not owed to anyone as of right. Finally, Hawkes’ emphasis on the changing profile of determinants of health over time, and the increasing impact of corporate behaviour on health, necessitate a recognition that, in addition to strengthening state governance, we must embrace a plurality of agents and duty-bearers in relation to human rights (and other global health considerations). As the UN Guiding Principles on Business and Human Rights make clear, this must include human obligations imposed directly on corporations. [11]

The Distinctiveness of Minimum Core Obligations

In the first report I analysed minimum core obligations as that sub-set of obligations associated with social, economic and cultural rights that are of immediate effect. In other words, all states are obligated to comply with them in full immediately. The MCOs, so understood, set a limit to the doctrine of progressive realisation, as Gorik Ooms also points out in his helpful comment. The latter doctrine, which appears in Article 2(1) of the ICESCR, enjoins states “to take steps, individually and through international assistance and co-operation, especially economic and technical, to the maximum of its available resources, with a view to achieving progressively the full realization of the rights recognized in the present Covenant by all appropriate means”. MCOs are a sub-set of obligations to which the progressive realization is inapplicable. I further claimed that although additional features, apart from immediacy, were commonly associated with MCOs – such as non-derogability, protecting special values, and justiciability – we should not interpret MCOs as necessarily possessing these other features. Instead, it should be left as a matter of substantive, case-by-case investigation whether a given MCO should be seen (as a matter of morality or law) as possessing any of these extra features. It is the idea of obligations of ‘immediate effect’ that is the core of the minimum core doctrine.

Now, the idea of an obligation of immediate effect, although apparently rather elementary and historically traceable back to Kant and beyond, can nonetheless be misunderstood. Unfortunately, it seems to me that both Max Harris and Katherine Young have misinterpreted the idea.

The most straightforward misunderstanding is Harris’. He takes the doctrine of MCOs to assume that “economic, social, and cultural rights cannot be secured in full”, and that therefore we should aim at the second-best solution of securing the sub-set of obligations associated with these rights that are “minimum core”. But this is a serious misconstrual of the idea of MCOs. It should go without saying that all properly justified human rights – including economic, social and cultural rights – should be fully secured. This is because securing them is a matter of obligation, and obligations are non-optional. There is no question of dividing up human rights obligations into a compulsory core component and an optional non-core component. Rather, the doctrine of MCOs tackles the question of what to do when, because of resource constraints, it is genuinely not feasible to secure all human rights immediately. Contrary to the impression conveyed by Harris, that is a question that is addressed in the ICESCR, in the first instance, not by the doctrine of MCOs but rather by the doctrine of progressive realization. The doctrine permits states to take steps to realise economic, social and cultural rights progressively over time where resource constraints preclude securing them immediately. MCOs set a limit to the operation of the doctrine of progressive realisation by specifying a sub-set of obligations that must be immediately satisfied in full by all states. Perhaps Harris is hostile to MCOs because he rejects the doctrine of progressive realisation, which sets up a contrast between economic, social, and cultural rights, on the one hand, and civil and political rights, on the other, as well as opening up the possibility of a sub-set of obligations associated with economic, social and cultural rights that must be immediately complied with. On this view, all human rights obligations are of immediate effect, with no leeway for progressive realization. Quite apart from the fact that such a view is heterodox as a matter of legal doctrine, I doubt that a cogent moral case exists for it.

A more sophisticated confusion about MCOs is to be found in the commentary by Katherine Young. She conflates minimum core obligations – obligations of immediate effect – with a very different idea, i.e. that of obligations that enjoy an absolute sequential priority in relation to their compliance. Hence, she seems to believe that I am committed to the idea that states are “require[d] [to] discharge core obligations towards primary education before other levels [of education] are addressed”. But this form of absolute sequential priority forms no part of the idea of minimum core obligations, as I explained them. The minimum core doctrine does not say that MCOs must always be fully complied with before a state embarks on any steps towards complying with non-core obligations; instead, it makes the far more moderate claim that, in a context where resource limitations preclude a state from complying with both core and non-core obligations, other things being equal it must prioritize the core obligations, leaving the non-core obligation to be progressively realized over time. [12]

An example from private life may serve to clarify the distinction between immediacy and absolute sequential priority that I have in mind. A parent, Brian, has an obligation to feed his child which is immediate – it must be realised here and now. Brian also has, let us say, a parental obligation to build up a fund for the future tertiary education of their child, an obligation that is to be progressively realised over time. May Brian undertake work during the day towards building up his child’s education fund before he cooks his child dinner that evening? Of course he may. Brian’s immediate obligation to provide dinner for the child is perfectly complied with, even if its fulfilment was preceded by a day’s work aimed at progressively realising the obligation to build up an education fund. If, however, Brian were going out to work in the evening in order to build up the education fund, leaving his child hungry at home, then he would be violating the immediate obligation. To call an obligation an obligation of immediate effect is not to say that non-immediate obligations may never be engaged with before the immediate obligation is complied with. Rather, it is to say that, in a situation of resource constraints that prevent both obligations being complied with, other things being equal the compliance with the immediate (core) obligation must not be sacrificed in favour of compliance with the non-core obligation.

So, let us shift now to an international illustration. If Bill Gates offers to pay the full costs of establishing and maintaining a tertiary education system in a less developed country, the government of that country is not required to turn away the gift on the basis that it must first fully comply with minimum core obligations. If the gift is expressly tied to this purpose, and its acceptance entails no further costs for the receiving state, then the state can accept it as part of the progressive realisation of its non-core obligations regarding education. This is because the non-core obligations are not being complied with by the state at the expense of the core obligations. If, instead, Gates had simply gifted the country a large sum of money, and the state chose to spend it on tertiary education, while leaving obligations to provide primary education unmet, then it would be contravening a minimum core obligation.

So, with this confusion between minimum core obligations and obligations that enjoy absolute sequential priority out of the way, it seems to me that there is no obstacle to Young embracing minimum core obligations. Indeed, she herself explicitly acknowledges the need for prioritization in the fulfilment of human rights obligations. Once freed of misinterpretation, minimum core obligations – or whatever else we choose to call obligations of immediate effect – are a key way of articulating these priorities.

Young also makes two somewhat cryptic remarks worth addressing. The first is that the Committee and other regional bodies have made “efforts” to “demarcate” minimum core obligations and obligations of immediate effect as “separate categories”. To this extent, she regards my interpretation of MCOs as departing from existing human rights law and practice. As Young recognises, even if this were true, it would not touch the main substance of my thesis, which is a moral case for recognising MCOs understood as immediate obligations. But even leaving this point aside, I find it difficult to respond to Young’s claim because she does not document any examples of where such a clear demarcation is made to set against my case for interpreting references to MCOs by the Committee as essentially obligations of immediate effect. Perhaps she means that the Committee has associated MCOs not just with the feature of immediacy, but also with features such as non-derogability and justiciability. This is something I repeatedly acknowledge in my first report, but there I also gave reasons for favouring a disaggregated conception of MCOs: making immediacy the core feature of MCOs, with the presence of other features to be determined on a case-by-case basis. I think this is the most attractive interpretation of MCOs that also fits the often unclear and inconsistent claims made on the topic by the Committee.

Young’s other remark is that my analysis of MCOs helps foster the unhealthy tendency to downgrade economic, social and cultural rights as compared with civil and political rights. Here I would make two points in reply. Insofar as we are talking about the two Covenants, it is clear that the doctrine of progressive realisation explicitly applies only to economic, social, and cultural rights. This ‘downgrading’ of socio-economic rights is a matter of law, not an artefact of my own theory. Second, in my report, I stated that once we have vindicated a role for MCOs in relation to socio-economic rights, we might logically be led to extend their application to civil and political rights, since resource constraints of the kind that arise in the case of the former also crop up in relation to the latter. Contrary to a formerly widespread mythology, civil and political rights cannot be contrasted with socio-economic rights on the basis that they are systematically non-burdensome or entail only ‘negative’ obligations. In my view, the moral force of MCOs, along with the idea of progressive realisation, is not confined to economic, social and cultural rights but applies to civil and political rights as well, whatever the existing legal situation may be. But this is a discussion for another occasion.

Gorik Ooms’ comment reminds us that although MCOs impose primary obligations on states in relation to their own people, they also impose secondary obligations on other states and international agents in the event, or likelihood, of non-compliance with those primary obligations. In my reports, I briefly addressed secondary obligations to assist states that are unable to comply with their MCOs. In addition, I also mentioned a secondary obligation not to impose conditions on states that will foreseeably lead to their inability to meet their MCOs, referencing the important work of Margot Salomon on the imposition of austerity measures on debtor countries. [13] Ooms’ comment goes further and, drawing on my analogy with parental obligations, contemplates an obligation to treat those governments that are able, but unwilling, to meet their MCOs in the way that we treat perpetrators of ‘crimes against humanity’. What is immediately in the offing here, presumably, is some form of intervention against the state in question or punishment of officials responsible for the MCO-violating policies.

If, as Ooms anticipates, my response to this bold proposal is somewhat guarded, this is for two reasons. First, I would be loath to build into the very concept of MCOs that they are triggers of intervention or punishment in the event of their extensive violation. And this for reasons similar to my resistance to interpreting MCOs as inherently non-derogable or justiciable. Building in this feature threatens to obscure the fundamental point of MCOs, which is to identify obligations of immediate effect associated with economic, social and cultural rights. There is no reason, a priori, to suppose that this concern maps neatly onto a norm relating to intervention or punishment. The result is that the fundamental point of MCOs risks being distorted. A more practical concern, which is a corollary of this one, is that linking MCOs in a wholesale way with intervention or punishment risks generating pressure to interpret them as more minimal demands than would otherwise be the case, given the severity of the consequences of breaching them. The second reason for my cautious reception of Ooms’ proposal is more general and relates to my scepticism about the tendency to move easily from normative claims about human rights to enforcement claims about intervention or punishment. I have outlined some of my misgivings on this front in criticising those trends in recent philosophy that essentially construe human rights as triggers for intervention. [14] But I think similar concerns extend to the tendency to perceive human rights through the lens of criminal law. These concerns are amplified in the case of violations of socio-economic rights which often concern structural matters for which a finding of criminal responsibility can be problematic. [15] None of this is to say that I reject Ooms’ intriguing proposal, but rather that I would like to see it fleshed out more fully. Any version of his proposal that is liable to be persuasive, I believe, will be more complex than a norm that simply appeals to the fact that some MCO has been extensively violated in a situation in which this could have been avoided.

Human rights today, as leading authorities have warned, are under pressure. [16] Some of these pressures are exogenous. They include rampant economic globalization, the rise of political authoritarianism, and a spreading ‘populist’ backlash. The external character of these pressures can foster the illusion that all human rights morality and law really needs is a combination of better PR and more effective enforcement mechanisms. But this would be an overly optimistic assessment, overlooking the extent to which human rights thought and practice has been undermined from within. These internal pressures often stem from a failure to grasp the proper, and limited, scope of human rights morality and, by extension, of international human rights law. The process of internal renewal that is needed is one that takes the philosophical underpinnings of human rights more seriously, including their nature as sources of obligation that do not exhaust the entire field of moral concern, as well as addressing questions of prioritization in the face of resource constraints. In this process of renewal, we will need to draw on a repertoire of concepts that we can articulate clearly and distinctly. MCOs are, I believe, an important component of this conceptual repertoire. As the insightful reflections of the contributors to this symposium show, their nature and potential warrant greater study by lawyers, philosophers, economists, ordinary citizens and others who are genuinely committed to the cause of human rights.

[1] The first report, which sets out a general framework for understanding the idea of minimum core obligations, is J. Tasioulas, Minimum Core Obligations: Human Rights in the Here and Now (Nordic Trust Fund / World Bank, 2017). The second report, which addresses minimum core obligations in relation to the human right to health, is J. Tasioulas, The Minimum Core of the Human Right to Health (Nordic Trust Fund / World Bank, 2017).

[2] J. Tasioulas, The Minimum Core of the Human Right to Health (Nordic Trust Fund / World Bank, 2017), pp.15-19.

[3] J. Tasioulas, ‘Custom, Jus Cogens and Human Rights’, in C. Bradley (ed.), Custom’s Future: International Law in a Changing World (CUP, 2016), pp.95-216.

[4] J. Kyl, D.J. Feith, and J. Fonte, ‘The War of Law: How New International Law Undermines Democratic Sovereignty’, Foreign Affairs July/August 2013.

[5] J. Tasioulas, ‘The Legitimacy of International Law’, in S. Besson and J. Tasioulas (eds), The Philosophy of International Law (Oxford University Press, 2010) and J. Tasioulas, ‘Human Rights, Legitimacy, and International Law’, American Journal of Jurisprudence (2013) 58: 1-25.

[6] For a fuller account, see J. Tasioulas, ‘Exiting the Hall of Mirrors: Morality and Law in Human Rights’, in T. Campbell and K. Bourne (eds), Political and Legal Approaches to Human Rights (Routledge, 2017).

[7] J. Tasioulas and E. Vayena, ‘The place of human rights and the common good in global health policy’, Theoretical Medicine and Bioethics (2016): 365-382, p.374 https://link.springer.com/content/pdf/10.1007%2Fs11017-016-9372-x.pdf

[8] A fuller discussion of considerations (b), (c) and (d) can be found in J. Tasioulas, ‘On the Foundations of Human Rights’, in R. Cruft, M. Liao, and M. Renzo (eds), Philosophical Foundations of Human Rights (Oxford University Press, 2015).

[9] M. Kumm, ‘Political Liberalism and the Structure of Rights: On the Place and Limits of the Proportionality Requirement’, in G. Pavlakos (ed.), Law, Rights and Discourse: The Legal Philosophy of Robert Alexy (Hart Publications, 2007), p.139.

[10] For powerful criticisms of the proportionality doctrine from this sort of perspective, see G. Verdirame, ‘Rescuing Human Rights from Proportionality’, in R. Cruft, M. Liao, and M. Renzo (eds), Philosophical Foundations of Human Rights (Oxford University Press, 2015) and F.J. Urbina, A Critique of Proportionality and Balancing (Cambridge University Press, 2017).

[11] Many of these points are developed further in J. Tasioulas and E. Vayena, ‘The place of human rights and the common good in global health policy’, Theoretical Medicine and Bioethics (2016): 365-382 https://link.springer.com/content/pdf/10.1007%2Fs11017-016-9372-x.pdf

[12] A similar confusion may also be at work in Harris’ claim that MCOs entail a ‘short-term’ outlook that leads to the neglect of ‘long-term investment or institution-building’. We can see that Harris’ conflation of MCOs with a policy of short-termism is mistaken from the fact that it makes perfect sense to engage in long-term investment and institution-building to secure MCOs in the future when they arise, e.g. the prevention of famine or the provision of primary education in years to come. Similarly, a parent may need to adopt long-term policies, e.g. maintaining a healthy lifestyle and diet, in order to be able to comply with their immediate obligations to their child now and in the future.

[13] J. Tasioulas, Minimum Core Obligations: Human Rights in the Here and Now (Nordic Trust Fund / World Bank, 2017), p.21

[14] J. Tasioulas, ‘Towards a Philosophy of Human Rights’, Current Legal Problems 65 (2012) pp.1-30.

[15] For a powerful antidote to a fixation on criminal law in relation to human rights, see the chapter entitled ‘The Awkwardness of the Criminal Law’ in O. Fiss, The Dictates of Justice: Essays on Law and Human Rights (Republic of Letters, 2011).

[16] P. Alston, ‘The Populist Challenge to Human Rights’, Journal of Human Rights Practice 9 (2017), pp.1-15.

Max Harris is an Examination Fellow in Law at All Souls College, Oxford. He is currently completing a DPhil in constitutional law and has worked as a consultant for the United Nations Development Programme.

The words ‘minimum core’ do not appear in the International Covenant on Economic, Social and Cultural Rights – or in the major regional human rights treaties. The idea of the minimum core of economic, social, and cultural rights is a gloss on what is in international human rights law, first introduced by the Committee on Economic, Social, and Cultural Rights in 1990 in a General Comment written by the Committee. That General Comment is not binding. It is therefore open to human rights lawyers, academics, and activists to choose to adopt or reject the doctrine of the minimum core; it is not inevitable that the doctrine is taken up. John Tasioulas, in two characteristically thoughtful papers for the World Bank (one on the minimum core doctrine in general, the other on the minimum core of the right to health), endorses the doctrine.

Tasioulas defines the minimum core – quite reasonably – as a “sub-set of obligations” associated with an economic, social, and cultural right, such as the right to housing or the right to education. For Tasioulas, we find the minimum core in obligations that must be complied with immediately. They must be “feasible” and “not unduly burdensome”.

In my view Tasioulas is too quick to accept the doctrine. He sees practical value in the minimum core: it helps, Tasioulas thinks, with “priority setting” where “resource implications” make it “inappropriate” to require full enforcement of economic, social, and cultural rights. But Tasioulas does not supply a positive argument for why it is inappropriate or impossible to enforce economic, social, and cultural rights in full. Political and cultural theorists, such as Mark Fisher, have argued that judgments of what is ‘possible’ or ‘realistic’ in politics are value-laden; they reflect assumptions about what governments can and should do. Legal theorists, including in international human rights law, ought to learn these same lessons and apply them to judgments of what is “feasible” or “unduly burdensome”. (Tasioulas does not define these terms, and in particular does not say when an obligation would be “unduly” burdensome.) Statements by present-day governments of what is feasible should not necessarily be accepted at face value. It might be that with significant rearrangement of those governments’ activities, enforcement of economic, social, and cultural rights would be eminently feasible.

As I have argued elsewhere, the privileging of core over non-core obligations therefore hollows out the potential of fully realised economic, social, and cultural rights. Tasioulas’ defence of the minimum core relies on the assumption that economic, social, and cultural rights cannot be secured in full; the minimum core is then presented as a second-best solution – the best that can be done in an imperfect world. Tasioulas considers the possibility that the minimum core doctrine might be “misunderstood” or “hi-jacked” in a way that sidelines parts of economic, social, and cultural rights. But the minimum core would not be “hi-jacked” if it involved the privileging of core over non-core obligations; indeed, prioritisation is meant to be one of the principal virtues of the doctrine.

Tasioulas also encourages the collection of empirical evidence to test whether the minimum core doctrine could result in sidelining of non-core obligations, and suggests an educative process could be conducted – along with other strategies being developed – if there was such sidelining. However, this is to mistake a conceptual problem for an empirical challenge to be managed. It is inherent in the concept of the minimum core that some normative hierarchy is created between core and non-core obligations. Empirical evidence can help to determine the effects of this hierarchy, but it cannot deny the existence of that hierarchy.

A further problem with Tasioulas’ account is what he says is prioritised through the minimum core doctrine: namely, obligations that can be immediately complied with. To prioritise these obligations is worrying from a development perspective. ‘Immediate compliance’ could conceivably mean one of two things. It could refer to obligations that a government can begin to take steps to comply with immediately. Or it could mean obligations that a government can completely comply with immediately. Because Tasioulas suggests that non-core obligations are subject to progressive realisation, he must understand ‘immediate compliance’ to mean the second of these options. The upshot of this is that the ‘immediate compliance’ account favours the sub-set of obligations that is short-term in outlook. Aspects of economic, social, and cultural rights that require long-term investment or institution-building cannot be protected by the minimum core. It is thus no surprise that Tasioulas concludes, in his paper on the right to health, that the minimum core of the right to health can include only “selective primary healthcare” as well as only partial delivery of Universal Health Coverage. This commitment to a short-term tilt, an approach grounded in the “here and now”, is unfortunate given that United Nations and NGO leaders have lamented the lack of long-term investment and institution-building in the world of development.

Overall, Tasioulas has drawn some helpful distinctions in these papers, in particular in sketching the difficult possible senses of ‘minimum core’, and has offered a useful review of the case law. But in resiling from the full enforcement of economic, social, and cultural rights he has been insufficiently ambitious. No minimum core exists for civil and political rights; to accept such a minimum core for economic, social, and cultural rights is to capitulate to a two-tier system of human rights protection that many human rights activists and academics have long resisted. Instead of the minimum core doctrine, judges might consider whether limits on economic, social, and cultural rights satisfy a test of proportionality (in jurisdictions where that is a usual part of judges’ human rights toolkit), or they might simply develop a more refined account of what is contained in individual economic, social, and cultural rights. Both alternative pathways would better realise the promise in the Vienna Declaration that human rights are “universal, indivisible, interdependent and interrelated.”

Sakiko Fukuda-Parr is a Professor of International Affairs at The New School. She is a development economist interested in human development and capabilities and the broad question of national and international policy strategies. Her current research includes projects on public policies and economic and social rights, and the impact of global goal setting on international development agendas.  Professor Fukuda-Parr serves on the UN Committee on Development Policy as Vice Chair, The Lancet-University of Oslo Commission on Global Governance for Health, and the boards of the International Association for Feminist Economics, the Center for Economic and Social Rights, and Knowledge Ecology International.

Minimum Core – translation of obligation of immediate effect as minimum level of rights enjoyment

In his report on the Minimum Core Doctrine (MCD) Tasioulas states: “the essence of the concept will be taken to be the sub-set of obligations associated with socio-economic rights that must be immediately complied with in full (obligations of immediate effect)” (p. 3). He contrasts these against those obligations that require significant resources and are therefore subject to ‘progressive realization’. Thus, the defining characteristic of MCD is that it differentiates obligations between those of immediate effect and those of progressive realization. And the focus is on the nature of the obligations (what the state must do when) rather than the nature of substantive rights (the condition of people’s lives).

However, the discussion about what constitutes minimum core obligations in substance focuses on the nature of rights enjoyment and a package of minimum goods and services that would be required rather than the nature of obligations. This starts with General Comment 3 that refers to ‘a minimum core obligation to ensure the satisfaction of, at the very least, minimum essential levels of each of the rights’, and to the provision of ‘essential primary health care’ (ICESCR quoted in Tasioulas p. 5). Further, human rights-based practice begins to specify specific types of diseases to be treated and goods and services that would be included in the minimum, as under the ‘selective primary health care model’ adopted by UNICEF (Tasioulas p. 5).

Thus, the concept of minimum core obligations has become translated as a right to a minimum set of goods and services, specifically identified with the provision of primary health care, including specific services such as oral rehydration therapy, immunization against six childhood diseases, and access to essential medicines on the WHO list. A key criterion in developing this list is affordability which makes immediate provisioning possible. Ironically – as I will discuss below – prevailing prices of such goods are therefore important to defining minimum core obligations rather than their importance for people in leading healthy lives.

This conception of MCD around low cost goods and services is unnecessarily restrictive. It is also out of line with concerns to meet pressing and priority health needs of the population. It departs from the original concept of obligations of immediate effect. It limits the consideration of the wide range of measures that national governments should take to expand the enjoyment of the right to health such as by reversing damaging policies or setting new ones. A salient example is policy choices governments might make in the area of intellectual protection provisions in free trade and investment agreements.

Intellectual property, trade agreements, and access to medicines

One of the pressing threats to the human right to health is the trend to include stronger intellectual protection in bilateral and plurilateral trade agreements. Since the introduction of the WTO TRIPS agreement that made strong intellectual property (IP) protection a requirement for all signatory countries, health and human rights activists have protested their effects on public health priorities, particularly in restricting access to life saving medicines^[1]. More than two decades on, even stronger IP provisions – ‘TRIPS Plus’ – have proliferated in new bilateral and plurilateral agreements, such as the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (TPP), that was agreed in January 2018 by 11 countries^[2]. These provisions strengthen patents held by pharmaceutical corporations by making patentability easier, and delaying the introduction of generic competition that would lead to lower prices and wider diffusion. Moreover, the new ‘trade agreements’ increasingly incorporate wide ranging provisions for investment – such as provisions for investor/state dispute settlement, public procurement, state owned enterprises and more – that strengthen investor rights and impose limitations on policy options for national governments in pursuing public health^[3]. These agreements are being negotiated with little consideration of their effects on the government obligation to fulfill the right to health; rarely are public health impact assessments made.

IP and trade policies for human right to health as a Minimum Core Obligation

There is much that countries can do to make IP-related trade agreements less damaging to public health priorities if not promote them^[4]. To start with, governments can make more proactive use of the flexibilities incorporated in the TRIPS agreement to make life saving medicines available at affordable prices. Countries can reject TRIPS plus provisions. Or they can also reject free trade agreements. These are all approaches that some countries – such as Thailand, Colombia, and Brazil have adopted. Even more important, countries that are defending IP holders interests, should refrain from joining corporations in taking retaliatory action against those countries that do use the flexibilities^[5]. For example, US government places countries that use TRIPS flexibilities on the Special 301 watch list that monitors IP enforcement and lists countries where enforcement is inadequate or weakening. One of the concerns is with “troubling indigenous innovation policies that may unfairly disadvantage U.S. rights holders in foreign markets.” (USTR 2018)^[6].

Though much has happened to expand access to life saving, high cost, patented drugs, and to invest in innovations for public health priorities, many gaps remain. Millions of people around the world lack access to medicines, and these include new branded medicines that carry very high prices – for example latest cancer drugs approved generally cost over US$100,000 for a year’s course of treatment, the new hepatitis C drug costs $1000 per pill or $84,000 for a course of treatment[7]. Access to such drugs is critical to life and is surely a priority for the fulfillment of the human right to health and the human right to life. Yet latest lifesaving drugs are not on the WHO essential medicines list as they are too expensive and cannot be provided universally. But this is because of the IP driven medical research and development system, enforced through trade agreements, that governments are obliged to comply with. At the same time, research and development (R&D) lag for high priority challenges because they do not offer attractive investment potential. This includes not only tropical diseases that afflict poor people and poor countries, but priorities for people of all levels of income, such as new antibiotics to combat growing antimicrobial resistance (AMR). Proactive government action, to coordinate internationally and promote priority investment in medical R&D by mobilizing public, private, and philanthropic resources would go a long way to fill these innovation gaps. Numerous initiatives have been taken in this direction but much more can be done.

Taking a proactive approach to designing trade and investment policies that align with public health priorities and that do not undermine the right to health is therefore an important human rights obligation of governments. I would argue that this is an important minimum core obligation because it is one that can be implemented with immediate effect, without large investment of resources. But many countries – particularly small developing countries – that have little economic or political clout in trade negotiations are faced with difficult trade-offs between joining trade and investment agreements to benefit from the global economy, and the need to protect policy space for pursuing their public health priorities. It is incumbent on all countries therefore to work collectively to promote systemic change and develop global principles and mechanisms for a more equitable policy framework for financing medical innovation. Many proposals have been made, not least by the series of global commissions that have addressed the contradictions between trade and health over the years. Pursuing these measures that would work towards greater equity in access to medicines – particularly all lifesaving medicines, and not just the inexpensive ones that are on the WHO essential medicines list – is surely a minimum core obligation of states necessary for the fulfillment of the human right to health.

^[1] While intellectual property protection rewards investors, it creates barriers for diffusion. It also hinders innovation for social priorities such as diseases of the poor that do not create a market demand. The tension is recognized in the TRIPS agreement itself that includes measures – commonly referred to as “TRIPS flexibilities” – that can be taken when the IP provisions get in the way of public health priorities.

^[2] Without the US that withdrew from the original 2016 agreement.

^[3] For summary discussion of these issues, see McNeil et al 2017.

^[4] For overview see report of the UN High Level Panel on Access to Medicines and Innovation 2017

^[5] Several cases have been documented since the early 2000s, such as the case of Thailand that has used a compulsory license for HIV/AIDS drug in 2006, to more recent case of Colombia’s effort to issue a compulsory license for a cancer drug. Such efforts have met with retaliatory actions such as corporations threatening to withdraw their products from the market, or with being put on US government’s Special 301 watch list of countries where IP enforcement is weakening.

http://www.ip-watch.org/2018/04/27/ustr-annual-special-301-report-seeks-intensify-action-china-colombia-canada/

https://www.ictsd.org/bridges-news/bridges/news/thailand-issues-compulsory-licence-for-patented-aids-drug

^[6] Office of the US Trade Representative, 2018 Special 301 Report.

https://ustr.gov/sites/default/files/files/Press/Reports/2018%20Special%20301.pdf

[7] http://www.pharmacytimes.com/resource-centers/hepatitisc/will-hepatitis-c-virus-medicaton-costs-drop-in-the-years-ahead

Gorik Ooms is a human rights lawyer and a global health scholar, Professor of Global Health Law & Governance at the London School of Hygiene & Tropical Medicine, Adjunct Professor at the Law Faculty of Georgetown University, and Visiting Professor at the Faculty of Medicine and Health Sciences of Ghent University. He is a member of the Lancet-O’Neill Institute and the Georgetown University Commission on Global Health and the Law. 

The concept of ‘minimum core obligations’ was originally advanced by the United Nation’s Committee on Economic, Social and Cultural Rights (henceforth, ‘the Committee’) to address the pitfall of ‘progressive realisation’, stipulated in the International Covenant on Economic, Social and Cultural Rights (henceforth, ‘the Covenant’).

For the readers who are not familiar with this legal jargon:

• Human rights can be broadly (and somewhat artificially) divided into two families: freedoms and entitlements. Freedoms are the rights we have because our societies are obliged to not do something: they are (somewhat misleadingly) called negative rights, because the corresponding obligation is negative. For example, our freedom of expression relies on societies not interfering when we express our opinion, no matter how much our society dislikes our opinion. Entitlements are the rights we have because our societies are obliged to do something: they are called positive rights, because the corresponding obligation is positive. For example, our entitlement to education relies on our society collecting financial resources and subsidising schools. While the Universal Declaration of Human Rights contains human rights of both families, freedoms and entitlements were separated when the International Covenant on Civil and Political Rights and the Covenant were written. Freedoms were included in the International Covenant on Civil and Political Rights, entitlements were included in the Covenant.
• Freedoms are supposed to be cheap for societies, as it does not cost anything to not interfere with people when they express their opinion, practice their religion and so on. Obviously, it can cost quite a lot to establish and run a police and justice system that will protect these freedoms – the idea that freedoms are cheap is an illusion. Nevertheless, all states that ratified the International Covenant on Civil and Political Rights are expected to realise all freedoms immediately. Entitlements are understood to be quite expensive. Therefore, states that ratified the Covenant are expected to realise all entitlements progressively. While we all have a right to attain the highest standard of health we can attain, the corresponding obligation of our societies is “to take steps”, in accordance with “maximum available resources” (Article 2(1) of the Covenant). Therefore, while we all have the same right to health, in principle, the efforts we can claim (like prevention or treatment) depend on the wealth of the society we live in.
• States that ratified the Covenant accepted to be monitored by a commission of experts: that is essentially the job of the Committee. The Committee understood that the concept of progressive realisation, while reasonable, became an easy excuse for states that did not really try hard. Therefore, in its General Comment 3, the Committee argued that “a minimum core obligation to ensure the satisfaction of, at the very least, minimum essential levels of each of the rights is incumbent upon every State party.” The crucial argument is that “[i]f the Covenant were to be read in such a way as not to establish such a minimum core obligation, it would be largely deprived of its raison d’être”. In other words: if states can easily argue that they are willing but, unfortunately, unable to realise these entitlement rights, these rights are meaningless.

As soon as the concept of minimum core obligations gained currency, it divided scholars. One the one hand, it seems to contradict the principle that ‘ought implies can’, in Latin: ‘ad impossibilia nemo tenetur’. Nobody, no state, can be held to do the impossible. To avoid that, we could define minimum core obligations at the level of whatever the poorest state is reasonably able to do. But that would set a standard at such a low level that it would deprive the concept of minimum core obligations of its raison d’être: only a handful of countries would be challenged by such a standard. In General Comment 14, on the right to health, the Committee followed a different path. In paragraph 43, it established a list of minimum core obligations, which include food, water, sanitation, housing, essential medicines… In paragraph 44, it established a list of “obligations of comparable priority”. Then in paragraph 45, it avoids the ‘ought implies can’ pitfall, by referring to another element in Article 2(1) of the Covenant, name the obligation to take steps “individually and through international assistance and co-operation”. In other words, if some states are willing but unable to meet their minimum core obligations, other states are obliged to step in: the ‘ought implies can’ principle is applied to all states (that ratified the Covenant) collectively; together, they can. While I support that interpretation, in principle, as long as states needing assistance have no practical means to make wealthier countries provide the assistance they should provide, it does not solve the problem.

John Tasioulas’ working papers on Minimum Core Obligations and The Minimum Core of the Right to Health have many virtues. The most brilliant element, in my opinion, is the way he deals with the abovementioned dilemma.

The baseline is not ascertained by asking what is feasible for the most dysfunctional or ‘failed’ state. This would be comparable to specifying the obligations of parenthood by reference to what is feasible for the most incompetent of parents. (Minimum Core Obligations, pages 23-24.)

Where should we look for the baseline then? In recent years, the concept of ‘failed states’ has been replaced by ‘fragile states’, or ‘fragile situations’. The World Bank keeps a Harmonized List of Fragile Situations. The list includes countries or territories with a low Country Policy and Institutional Assessment (CPIA) score, and/or the presence of a United Nations and/or regional peace-keeping or political/peace-building mission during the last three years, if these countries or territories are eligible for support from the International Development Association (IDA). The IDA – also known as the ‘soft loan arm’ of the World Bank – supports ‘low income countries’: countries with a Gross National Income (GNI) of less than US$1005 per capita. So, a practical and sensible approach would be to look at the states that have a capacity immediately above these fragile states: countries that are about to ‘graduate’ from low income country status, with a better CPIA score and no recent peace-keeping or peace-building interventions. Senegal comes to mind: the GNI per capita is $950 according to the World Bank Atlas method. Or Cambodia, where the GNI per capita is $1140.

Looking at the level of ‘efforts to improve health’ (healthcare, water, sanitation, housing,…) these countries do provide would only be the first step. What we really want to know is the baseline these countries can provide.

Once we would have such a baseline established, a double question arises:

• What should the international community do with regards to countries that are willing but unable to achieve the baseline?
• What should the international community do with regards to countries that are able but unwilling to achieve the baseline?

Here again, Tasioulas’ brilliant analogy provides guidance (although I am not sure he would agree). Countries that are willing but unable to live up to their minimum core obligations should be treated like we would treat parents that are willing but unable to be responsible parents: the international community should assist them, not as a matter of charity but as a matter of justice. Countries that are able but unwilling to live up to their minimum core obligations should be treated like we would treat parents that are able but unwilling to be responsible parents. They should be treated as states that violate human rights on a scale – if measured by the consequences – that may exceed most acknowledged ‘crimes against humanity’. The international community has a responsibility to protect the people of these countries.

Katharine Young is an Associate Professor of Law at Boston College Law School.  Her scholarship focuses on comparative constitutional law, economic and social rights, constitutional theory and positive state obligations, international human rights law, and public law and gender.

In his report to the World Bank on the highly contested concept of “Minimum Core Obligations” in international human rights law, Professor Tasioulas proposes an interpretation which equates the concept with unqualified temporal priority: minimum core obligations are the sub-set of obligations associated with economic, social and cultural rights that must be immediately complied with in full by all states. These are special obligations, he suggests, to which the ICESCR’s express doctrine of “progressive realization” does not apply. These obligations are understood as invariant in content for all states parties (despite states’ different background resources), uniform and constrained by their connection to a particular right. They are to take priority, ceteris paribus, over other obligations associated with economic, social and cultural rights.

I have great sympathy for efforts to limit the reach of the progressive realization doctrine, and to reinforce the conceptual priors that drive the content of economic, social and cultural rights. And Tasioulas’s preference for an approach that directs attention to the time frame in which obligations must be discharged is very important. Yet his equation of priority with immediacy is a short-term, ameliorative, and likely counterproductive approach to the intolerable and all-too familiar delay that attends these rights. In this brief comment, I want to outline what I take to be the broad question of temporality in the ordering of economic, social and cultural rights obligations, the way Tasioulas’s answer may minimize it, and why it matters.

Let me first commend the important contribution, to public policy audiences, offered by the crisp distinction of the various roles imported onto the minimum core concept. Since the Committee on Economic, Social and Cultural Rights first expressed the view, in 1990 with General Comment No. 3, that where a “significant number of individuals is deprived of essential foodstuffs, of essential primary health care, of basic shelter and housing, or of the most basic forms of education”, that state is “prima facie, failing to discharge its obligations”, that seemingly uncontroversial view has been deployed in multiple ways. The concept itself has stood in as a proxy for rules of justiciability or non-derogation, or to the values of human dignity or basic needs.[1] Indeed, my 2008 article pointed to these competing – and often incompatible – interpretations as a reason for directing research and practical energies elsewhere: first, to improve the reliability of indicators and other monitoring data in measuring realization, including of the rights of the most vulnerable; second, to explore balancing and proportionality as doctrines that have become flexible, if highly debated, tools to enforce rights; and third, to give concrete content to the extraterritorial obligations set out in article 2(1) of the ICESCR and elsewhere. And indeed, it is in these directions that the last decade of scholarship on economic and social rights have focused, alongside the recognition that such rights, while becoming standard in many of the world’s constitutions and statutes, were diverging in substantive legal content.[2]

And yet the minimum core persists: attractive to those who might think a minimalist content is the most we can hope for under background conditions of extreme poverty and inequality and invariably limited resources. For Tasioulas, this means ascribing temporal priority – that minimum core obligations should be those of “immediate effect”. Let us leave to one side that this interpretation is contrary to the Committee’s and other regional efforts to demarcate “minimum core obligations” and “immediate obligations” as separate categories, and to interpret each in light of the indivisibility and interdependence of all human rights. Perhaps departures such as Tasioulas’s may be warranted – interpretive efforts are not always consistent and may anyway be evolving. Instead, let us examine what is implied by a strategy to limit the doctrine of “progressive realization” by expanding the reach of the minimum core.

I suggest that this proposal for “minimum core obligations”, which are to be discharged immediately and prior to other obligations, replicates age-old distinctions between categories of rights, and fails to appreciate the distinctiveness of the idea that, when moral rights are transposed to legal rights, they create legal duties on the state (as a primary matter). The preferable view is to maintain an interpretation of economic, social and cultural rights that is conducive to regional and network efforts at setting standards, more open to claimants’ demands, and better equipped to address the prevailing framework of laws that contribute to such stark material deprivation.

First, advocates of the distinction between “first generation” civil and political rights, and “second generation” economic, social and cultural rights claimed that these two types of rights were fundamentally different, in that only the former could lead to obligations of immediate effect. The argument in support of economic, social and cultural rights had to overcome precisely that view, by proving that that immediacy did not correlate with importance. Tasioulas’s attempt to privilege a sub-set of economic, social and cultural rights that acquire this same status essentially brings back that ill-fated distinction, only this time internal to the category of economic, social and cultural rights.

While some interpretations of progressive realization also reinforce that distinction, the better view is that the obligation does not set out a space of unaccountable delay whenever resources are required. An obligation towards progressive achievement, as it appears in the Universal Declaration of Human Rights of 1948, applies to all rights; its special formulation for economic, social and cultural rights was contested at the time of the ICESCR’s drafting, with some representatives suggesting a reasonable time frame, or even a time limit, should accompany the clause. The Committee’s General Comments have pointed to an obligation to take expeditious and effective steps as part of progressive realization, and duties of non-retrogression have also been analysed. And the omission of progressive realization in subsequent treaties, such as in CEDAW – despite some reversals, such as the CRPD – might suggest a recognition that accountability and appropriate flexibility can be generated without it.

In addition to reviving that distinction, Tasioulas misunderstands the nature of the primary duty bearer: the state. His emphasis on an unqualified priority for certain obligations fails to appreciate that, for the state, temporal sequence cannot be commanded by a “minimum core” of rights. Immediacy in fact pertains to all claimants. The most vulnerable can, of course, demand special duties, but to insert a doctrine which requires other obligations to be suspended until those duties are discharged is to misunderstand this role. It may play into certain neoliberal prescriptions that have been discredited on various grounds, as my 2008 article warned, and at the very least entrench a stunted idea of state obligations to oversee – and even to plan – the economy.

Let me demonstrate with an example from the right to education. Tasioulas asserts that a state cannot prioritize high-level research institutes over the provision of primary schools. This point is, of course, elementary and wholly independent of the proposed minimum core doctrine: the ICESCR itself, in one of its longest articles, sets out important priorities. Primary education is to be compulsory and free for all; higher education is to be equally accessible, on the basis of capacity.[3] But to require the discharge of core obligations towards primary education before other levels are addressed is to misunderstand this article, the much more nuanced General Comment No. 13, and the task of a state. How might a government respond to a transnational corporation, seeking to market secondary and tertiary education, for instance, if it is to be put in breach of its duties if it does not wait until primary education is secured? Clearly, a state’s legal obligations to take steps to regulate this sector are just as important – and just as immediate – as the former.

Delay of rights is akin to denial of rights – a premise recognized, among other charters of rights, in the 1215 Magna Carta. The intolerable waiting associated with the full realization of economic and social rights must be monitored: infringements, including those induced extraterritorially, must give rise to enforcement (encompassing the soft measures Tasioulas helps to specify). This interpretation is consistent with the idea that economic and social rights rest on freedoms that are both especially important and socially influenceable, in one important formulation:[4] an interpretation which extends to all economic and social rights, not just those confined to a “minimum core”. Human rights are designated – and warrant that designation – because they are for the here and now. We should not elevate a minimalist, ameliorative and short-term doctrine in order to make that clear.

[1] Katharine G. Young, The Minimum Core of Economic and Social Rights: A Concept in Search of Content, 33 Yale J. Int’l L. 113 (2008).

[2] See, e.g., the many contributions of the forthcoming The Future of Economic and Social Rights (Katharine G. Young, ed., Cambridge University Press), including, as especially pertinent, Ran Hirschl et al, Justiciable and Aspirational ESRs in National Constitutions; and Olivier de Schutter, A Proposed Framework on Progressive Realization and Public Finance.

[3] ICESCR, art. 13.

[4] E.g., Amartya Sen, ‘Elements of a Theory of Human Rights’ (2004) 32 Philosophy and Public Affairs 315-356.